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CITY OF SANTA ANA. <br />PROPOSAL <br />PROTECT NO.: 17-6882 <br />LOCAL STREET SLURRY SEAL 2016-17 <br />STATEMENT REGARDING "ANTI -KICKBACK" REQUIREMENTS <br />The undersigned is submitting this proposal for performing by contract the work required by <br />these bid documents, agrees to comply with the Copeland "Anti -Kickback" Act (18 USC 74) as <br />supplemented in the Department of Labor regulations (29 CFR, Part 3). This act provides that <br />each contractor or subcontractor shall be prohibited from inducing, by any means, any person <br />employed in the construction or repair of public work, to give up any part of the compensation to <br />which he/she is other io'e ei rt1ed, <br />Signed: ...__._ <br />Title: President <br />Firm: Pavement Coatings Co, <br />Date: 5522/17 <br />P -IS of P-16 <br />